The DOI matches its Crossref record; 181 of the 181 references it cites were found in a registry or an index.
Systematic review of the comorbidity of irritable bowel syndrome with other disorders: What are the causes and implications?
Abstract
Background & aims Comorbid or extraintestinal symptoms occur frequently with irritable bowel syndrome and account for up to three fourths of excess health care visits. This challenges the assumption that irritable bowel is a distinct disorder. The aims of this study were to (1) assess comorbidity in 3 areas: gastrointestinal disorders, psychiatric disorders, and nongastrointestinal somatic disorders; and (2) evaluate explanatory hypotheses.Methods The scientific literature since 1966 in all languages cited in Medline was systematically reviewed.Results Comorbidity with other functional gastrointestinal disorders is high and may be caused by shared pathophysiological mechanisms such as visceral hypersensitivity. Psychiatric disorders, especially major depression, anxiety, and somatoform disorders, occur in up to 94%. The nongastrointestinal nonpsychiatric disorders with the best-documented association are fibromyalgia (median of 49% have IBS), chronic fatigue syndrome (51%), temporomandibular joint disorder (64%), and chronic pelvic pain (50%).Conclusions Multivariate statistical analyses suggest that these are distinct disorders and not manifestations of a common somatization disorder, but their strong comorbidity suggests a common feature important to their expression, which is most likely psychological. Some models explain the comorbidity of irritable bowel with other disorders by suggesting that each disorder is the manifestation of varying combinations of interacting physiological and psychological factors. An alternative hypothesis is that the irritable bowel diagnosis is applied to a heterogeneous group of patients, some of whom have a predominantly psychological etiology, whereas others have a predominantly biological etiology, and that the presence of multiple comorbid disorders is a marker for psychological influences on etiology.
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In the citing paper
“it is becoming increasingly understood how psychological co-morbidity may have an impact on gastrointestinal function, [30, 31, 32, 33] and vice versa, [34, 35]”
From Efficacy of psychological therapies for irritable bowel syndrome: systematic review and network meta-analysis (2020) · cites this paper as [32]
In the citing paper
“Many IBS patients have at least one co-morbid somatic complaint and many meet diagnostic criteria for other functional disorders.”
From Irritable Bowel Syndrome and Co-morbid Gastrointestinal and Extra-gastrointestinal Functional Syndromes (2010) · cites this paper as [4]
In the citing paper
“Studies of IBS among patients with chronic fatigue syndrome have reported a prevalence ranging from 35-92%.”
From Irritable Bowel Syndrome and Co-morbid Gastrointestinal and Extra-gastrointestinal Functional Syndromes (2010) · cites this paper as [4]
In the citing paper
“Many IBS patients have at least one co-morbid somatic complaint and many meet diagnostic criteria for other functional disorders.”
From Irritable Bowel Syndrome and Co-morbid Gastrointestinal and Extra-gastrointestinal Functional Syndromes (2010) · cites this paper as [4]
In the citing paper
“The studies are consistent in their finding that the overlap among these disorders is greater than expected based on their separate prevalence rates.”
From Irritable Bowel Syndrome and Co-morbid Gastrointestinal and Extra-gastrointestinal Functional Syndromes (2010) · cites this paper as [4]
In the citing paper
“In addition, patients with more than 1 disorder have greater disease severity, higher rates of psychopathology, and more severely impaired health-related quality of life than those with only 1 disorder.4”
From Irritable Bowel Syndrome and Co-morbid Gastrointestinal and Extra-gastrointestinal Functional Syndromes (2010) · cites this paper as [4]
In the citing paper
“There is substantial overlap between IBS and other FGID, such as functional dyspepsia.”
From Irritable Bowel Syndrome and Co-morbid Gastrointestinal and Extra-gastrointestinal Functional Syndromes (2010) · cites this paper as [4]
In the citing paper
“Studies of IBS among CFS patients have reported a prevalence ranging from 35-92%34-38 with a median of 51%.4”
From Irritable Bowel Syndrome and Co-morbid Gastrointestinal and Extra-gastrointestinal Functional Syndromes (2010) · cites this paper as [4]
In the citing paper
“In summary, many IBS patients have at least 1 co-morbid somatic complaint and many of them meet diagnostic criteria for other gastrointestinal and extraintestinal functional disorders.”
From Irritable Bowel Syndrome and Co-morbid Gastrointestinal and Extra-gastrointestinal Functional Syndromes (2010) · cites this paper as [4]
In the citing paper
“Furthermore, in the systemic review, Whitehead et al. (20) reported that between a quarter and a third of patients with IBS meet the criteria for somatization disorder, which is much higher than in the normal population.”
From Psychosocial Distress and Somatic Symptoms in Community Subjects With Irritable Bowel Syndrome: A Psychological Component Is the Rule (2009) · cites this paper as [20]
In the citing paper
“It is well known that psychological and psychiatric comorbidity is common among patients with IBS (17,20,40).”
From Psychosocial Distress and Somatic Symptoms in Community Subjects With Irritable Bowel Syndrome: A Psychological Component Is the Rule (2009) · cites this paper as [20]
In the citing paper
“The definition of PPPD paralleled work in other areas of medicine where functional disorders (e.g., the functional gastrointestinal disorders [25, 91] and fibromyalgia [93, 94]) were defined by their core physical symptoms and not associated psychological features.”
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“Temporomandibular joint (TMJ) disorder [30, 77], fibromyalgia syndrome [2, 30, 77], visceral hypersensitivity [2, 38], food hypersensitivity [40, 60], sleep disorders [30, 40], spondyloarthropathy [86], chronic liver disease [30], a history of dysentery [45], restless leg syndrome [36], having…”
Huang, H., Lu, L., Chen, Y., Zeng, Y., & Xu, C. (2022) · Nutrition Journal · doi:10.1186/s12937-022-00777-x · Cited by 33
“Psychological conditions, such as anxiety and depression, often coexist with IBS [58].”
BackgroundAbraham, S. F., & Kellow, J. E. (2011) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2010.11.009 · Cited by 30
More similarities than differences between men and women with irritable bowel syndrome
Björkman, I., Ung, E. J., Ringström, G., Törnblom, H., & Simrén, M. (2015) · Neurogastroenterology & Motility · doi:10.1111/nmo.12551 · Cited by 31
Carmona-Sánchez, R., & Tostado-Fernández, F. Á. (2005) · PubMed · Cited by 30
Charapata, C., & Mertz, H. (2006) · Neurogastroenterology & Motility · doi:10.1111/j.1365-2982.2005.00750.x · Cited by 30
Panisch, L. S., & Tam, L. M. (2019) · Trauma Violence & Abuse · doi:10.1177/1524838018821950 · Cited by 30
Liu, Y.-W., Wang, Y., Yen, H.-F., Liu, P.-Y., Tzeng, W.-J., Tsai, C.-F., Lin, H., Lee, F., Jeng, O.-J., Lu, C., et al. (2019) · Probiotics and Antimicrobial Proteins · doi:10.1007/s12602-019-09595-w · Cited by 29
Guilarte, M., Vicario, M., Martínez, C., de Torres, I., Lobo, B., Pigrau, M., González-Castro, A., Rodiño-Janeiro, B., Salvo-Romero, E., Fortea, M., et al. (2020) · American Journal of Gastroenterology · doi:10.14309/ajg.0000000000000789 · Cited by 28
Brain Functional Interaction of Acupuncture Effects in Diarrhea-Dominant Irritable Bowel Syndrome
Ma, K., Liu, Y., Shao, W., Sun, J., Li, J., Fang, X., Li, J., Wang, Z., & Zhang, D. (2020) · Frontiers in Neuroscience · doi:10.3389/fnins.2020.608688 · Cited by 29
Emotional stress reactivity in irritable bowel syndrome
Bach, D. R., Erdmann, G., Schmidtmann, M., & nnikes, H. (2006) · European Journal of Gastroenterology & Hepatology · doi:10.1097/00042737-200606000-00009 · Cited by 29
Malocclusion, Mastication and the Gastrointestinal System
Proff, P. (2010) · Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie · doi:10.1007/s00056-010-0909-8 · Cited by 29
“The frequent coincidence of temporomandibular disorders and irritable bowel syndrome is usually viewed in a psychosomatic context nowadays [82, 99 ].”
BackgroundDipnall, J. F., Pasco, J. A., Berk, M., Williams, L. J., Dodd, S., Jacka, F. N., & Meyer, D. (2016) · PLoS ONE · doi:10.1371/journal.pone.0167055 · Cited by 29
Schauer, B., Grabe, H. J., Ittermann, T., Lerch, M. M., Weiß, F. U., Mönnikes, H., Völzke, H., Enck, P., & Schwille‐Kiuntke, J. (2018) · Neurogastroenterology & Motility · doi:10.1111/nmo.13511 · Cited by 29
A cognitive behavioural based assessment of women with chronic pelvic pain
Weijenborg, P. T. M., ter Kuile, M. M., & Stones, W. R. (2009) · Journal of Psychosomatic Obstetrics & Gynecology · doi:10.3109/01674820903378742 · Cited by 29
“Co-morbid symptoms like dysmenorrhoea and dyspareunia [4,6,15,16] as well as co-morbid syndromes like irritable bowel syndrome [17], interstitial cystitis [18], chronic fatigue syndrome, and fibromyalgia [19] are frequently observed.”
BackgroundChronic widespread pain and neurophysiological symptoms in joint hypermobility syndrome (JHS)
Clark, C., Khattab, A., & Carr, E. (2014) · International Journal of Therapy and Rehabilitation · doi:10.12968/ijtr.2014.21.2.60 · Cited by 28
Gucht, V. D., Fischler, B., & Heiser, W. J. (2003) · Stress and Health · doi:10.1002/smi.975 · Cited by 31
Asare, F., Störsrud, S., & Simrén, M. (2012) · Current Gastroenterology Reports · doi:10.1007/s11894-012-0268-2 · Cited by 29
Polster, A. V., Friberg, P., Gunterberg, V., Öhman, L., Nevé, B. L., Törnblom, H., Cvijović, M., & Simrén, M. (2018) · Neurogastroenterology & Motility · doi:10.1111/nmo.13320 · Cited by 31
Donnachie, E., Schneider, A., & Enck, P. (2020) · Scientific Reports · doi:10.1038/s41598-020-66685-4 · Cited by 27
Ayadilord, M., Mahmoudzadeh, S., Hoseini, Z. S., Askari, M., Rezapour, H., Saharkhiz, M., Abbaszadeh, A., Karbasi, S., Dasht-e-Bayaz, N. Z., Ferns, G. A., et al. (2020) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-020-05659-3 · Cited by 30
Roth, B., Larsson, E., & Ohlsson, B. (2022) · Journal of Gastroenterology and Hepatology · doi:10.1111/jgh.15830 · Cited by 27
Wells, M. M., Roth, L., & Chande, N. (2012) · The American Journal of Gastroenterology · doi:10.1038/ajg.2011.486 · Cited by 27
Irritable Bowel Syndrome and Psychiatric Disorders in Pakistan: A Case Control Study
Butt, A. S., Salih, M., Jafri, W., Yakoob, J., Wasay, M., & Hamid, S. S. (2012) · Gastroenterology Research and Practice · doi:10.1155/2012/291452 · Cited by 27
Increased Risk of Miscarriage and Ectopic Pregnancy Among Women With Irritable Bowel Syndrome
Khashan, A. S., Quigley, E. M. M., McNamee, R., McCarthy, F. P., Shanahan, F., & Kenny, L. C. (2012) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2012.02.014 · Cited by 27
Guided self-help interventions for irritable bowel syndrome
Liegl, G., Plessen, C. Y., Leitner, A., Boeckle, M., & Pieh, C. (2015) · European Journal of Gastroenterology & Hepatology · doi:10.1097/meg.0000000000000428 · Cited by 28
Management of Chronic Visceral Pain
Olesen, A. E., Farmer, A. D., Olesen, S. S., Aziz, Q., & Drewes, A. M. (2016) · Pain Management · doi:10.2217/pmt-2015-0011 · Cited by 28
Yang, T.-Y., Chen, C., Lin, C., Lin, W., Kuo, C.-N., & Kao, C. (2017) · Medicine · doi:10.1097/md.0000000000006657 · Cited by 27
“INTRODUCTION I rritable bowel syndrome (IBS) is a common functional disorder of the gastrointestinal tract that is characterized by chronic abdominal pain or discomfort.(1) IBS pathogenesis can involve an altered intestinal motility,(2) visceral hypersensitivity,(3) altered compliance of the gut wall,(4) psychological…”
BackgroundMethodBennet, S., Palsson, O. S., Whitehead, W. E., Barrow, D. A., Törnblom, H., Öhman, L., Simrén, M., & van Tilburg, M. A. L. (2018) · Neurogastroenterology & Motility · doi:10.1111/nmo.13378 · Cited by 27
Self-citationShiotani, A., Kusunoki, H., Kimura, Y., Ishii, M., Imamura, H., Tarumi, K.-I., Manabe, N., Kamada, T., Hata, J., & Haruma, K. (2013) · Digestive Diseases and Sciences · doi:10.1007/s10620-013-2677-y · Cited by 26
High Somatic Symptom Burdens and Functional Gastrointestinal Disorders
Sayuk, G. S., Elwing, J. E., Lustman, P. J., & Clouse, R. E. (2007) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2006.11.024 · Cited by 26
Mohsenabadi, H., Zanjani, Z., Shabani, M. J., & Arj, A. (2018) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2018.07.003 · Cited by 26
Metadata
- Authors
- Whitehead, W. E., Palsson, O., & Jones, K. R.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Venue
- Gastroenterology
- Publisher
- Elsevier BV
- Published
- 2002-04
- Volume
- 122
- Issue
- 4
- Pages
- 1140-1156
- ISSN
- 0016-5085 (ISSN-L)
- OpenAlex
- W2145558296
- Cited by
- 1,116
- References
- 180
- Citations by year
- 2026: 26 · 2025: 16 · 2024: 29 · 2023: 27 · 2022: 63 · 2021: 53 · 2020: 53 · 2019: 49 · 2018: 50 · 2017: 51 · 2016: 63 · 2015: 51 · 2014: 64 · 2013: 55 · 2012: 54
- FWCI
- 6.74
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK031369, R01 DK31369)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Keywords
- irritable bowel syndrome, comorbidities, extraintestinal manifestations, functional gastrointestinal disorders, mental illness, depression, anxiety, somatoform disorders, fibromyalgia, chronic fatigue syndrome, temporomandibular disorders, chronic pelvic pain, visceral hypersensitivity, somatization, psychological etiology
- MeSH terms
- Mental Disorders, Colonic Diseases, Functional, Gastrointestinal Diseases, Humans, Psychophysiologic Disorders, Comorbidity
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